When progressive enlargement of a multinodular goiter causes symptomatic tracheal compression, the preferred management in otherwise good-risk patients is:

C. Surgical resection of the abnormal thyroid.

DISCUSSION: When a multinodular goiter enlarges enough to cause symptoms of tracheal compression, surgical treatment is usually required if the patient is considered a reasonable operative risk. Medical treatment may be effective in preventing the initial growth of the goiter but is unlikely to cause enough regression to relieve symptoms. Radioactive iodine can occasionally be used to cause some regression in patients who are poor anesthesia risks, but this is a temporizing treatment rather than a definitive one.